Stigma describes prejudicial attitudes, negative stereotypes, and discrimination targeting a subgroup. Various forms of stigma have been identified in the literature, including self-stigma. Self-stigma or internalized stigma occurs when stigmatized individuals become aware of the negative stereotypes and apply these to themselves. Self-stigma may be a barrier to career development and employment in individuals with Autism Spectrum Disorder (ASD). However, there are few data available on the presence of self-stigma among young adults with ASD in Chile to inform local interventions and policies.

To analyze self-stigma and its relation with career development and employment in young adults with ASD in Chile.

A mixed-method observational study was conducted to analyze self-stigma and its association with career development and employment among young adults with ASD in two regions of Chile. For the quantitative analysis, self-stigma was assessed using the Internalized Stigma of Mental Illness (ISMI) scale, and employment information was collected. For the qualitative analysis, in-depth interviews were conducted. Data from the interviews were digitalized and transcribed, and the analysis was conducted using ATLAs.ti following the principles of Glaser and Strauss’s Grounded Theory. All participants provided written informed consent, and the study was approved by the local Institutional Review Board.

Overall, 356 participants were included in the quantitative analysis (mean age: 27.8 [SD 6.2] years, 44.7% women, 14.8% with regular employment). The mean ISMI for the total sample was 2.34 (SD = 0.62). By triangulating this information with the qualitative analysis (n=27), it was observed that young adults with ASD frequently experience self-stigma attitudes. Through the in-depth interviews, we identified barriers and facilitators for the development of self-stigma. Also, we identified that negative self-perceptions among young adults with ASD may be a barrier to seeking career development opportunities and employment in this population.

The current study shows self-stigma is present in young adults with ASD in Chile, and this may impact negatively their career development and employment.

None Declared

To assess the effect of different front-of-package labelling (FOPL) schemes on the objective understanding of the nutritional content and intention to purchase products, in Panama.

Single-blinded multi-arm parallel-group randomised controlled trial.

Supermarkets across Panama. Participants were exposed to two-dimensional images of fifteen mock-up products presented at random and balanced orders. Participants assigned to the intervention groups were exposed to mock-ups featuring one FOPL scheme: black octagonal warning labels (OWL), traffic-light labelling (TFL) or guideline daily amounts (GDA). The control group was not exposed to any FOPL scheme.

Adult supermarket shoppers (n 1200). Participants were blinded to group assignment.

A similar number of participants were randomised and analysed in each group: OWL (n 300), TFL (n 300), GDA (n 300) and control (n 300). The odds of choosing to purchase the least harmful or none of the options more often was the highest in the OWL group. Compared with the control group, these odds were two times higher in the OWL group (OR 2·13, 95 % CI 1·60, 2·84) and 57 % higher in the TFL (1·57, 1·40–2·56), with no changes in the GDA (0·97, 0·73–1·29). OWL also resulted in the highest odds for correctly identifying the least harmful option and for correctly identifying a product with excessive amounts of sugars, sodium and/or saturated fats.

OWL performed best in helping shoppers to correctly identify when a product contained excessive amounts of nutrients of concern, to correctly identify the least harmful option and to decide to purchase the least harmful or none of the options, more often.

Previous studies suggest that adults with mental disorders (MD) or Autism Spectrum Disorder (ASD) are more likely to be unemployed than those without MD. However, it is unclear whether working adults with MD or ASD perceive the same effort-reward balance as their counterparts without MD or ASD.

To analyze labor conditions and to identify factors associated with effort-reward imbalance among young adults with ASD, MD and those from the general population (GP).

A qualitative and quantitative study design is being conducted to analyze the rates of employment among young adults with ASD, and to identify factors associated with employment rates (Fondecyt ID11201028.). As part of this study, we conducted a quantitative analysis in young adults 16 to 30 years of age in two regions of Chile between August and October, 2022. Young adults with MD and ASD were compared with adults of similar age recruited from the GP. We applied a questionnaire to collect data on participant’s sociodemographic information, autonomy level and employment status. We applied the short Spanish version of the effort–reward imbalance (ERI) and overcommitment (OC) questionnaire, which has been widely used in Latin American countries.

Chi-square test was used and the Kruskal Wallis H Test was applied to compare among groups. The statistical significance was set at P<0.05.

Overall, 422 participants were included in the analysis (mean age 22±3.2, 64.2% women, 65.2% students, and 4.4% unemployed). Of the total respondents, 22% of young adults from GP, 17.8% with MD, and 4.8% with ASD were working at the moment of the survey. Regarding autonomy level, a higher proportion of participants with ASD needed support (36.4%), compared with 9.7% and 0.8% of young adults with MD and GP, respectively. Of the population who reported working (n=125), about 56.0% have a permanent job, and 44% a seasonal or occasional job. The median value for the effort–reward ratio was 0.96 (range 0.4–1.8), with no significant differences between the groups. Of those participants working, 44.3% showed an ERI ratio higher than 1, which was higher in participants with ASD (60%). ERI-esteem was significantly different (P=0.01) among ASD (7.0; range 5-8), MD (6.0; range 2-8) and PG (6.0; range 2-8). In the OC questionnaire, young adults with ASD were more likely to think about work (P=0.01) and having trouble sleeping at night due to work issues (P=0.03) than GP and MD groups.

The ASD group showed higher overcommitment and a considerable proportion of subjects at risk of effort-reward imbalance at work, were more likely to think about work at home, and had trouble sleeping thinking about work. Our preliminary results highlight the importance of considering the working conditions of young adults diagnosed with ASD and the need to provide them with enough support to promote labor inclusion.

None Declared

Risk of functional impairment and progression to chronic illness in people with a first episode of psychosis (FEP) has motivated early intervention programs, showing promising results. Defining the characteristics of people with FEP at local level enables the clinicians to adjust interventional models to the reality of the population. The area 5 of Madrid (Spain) is referred to La Paz University Hospital and it serves a catchment area of roughly 527,000 people.

We aim to identify sociodemographic and clinical characteristics of patients in the area 5 of Madrid (Spain) who meet the criteria of FEP.

A descriptive retrospective study including 179 people (age range 18-40 years) who were attended in mental health services of La Paz University Hospital (area 5 of Madrid, Spain), between January 2019 and May 2020, having suffered a psychotic episode in the last five years.

The average age of people with FEP was 29.32 years, with a higher proportion of men (62%). The mean duration of untreated psychosis (DUP) was 3.64 months and 47% of patients consume cannabis. We found disparities in DUP among the different districts in the area and we also observed differences depending on the district for inclusion in rehabilitation programs or psychotherapy. The following averages were obtained for the aggregate sample: 1.01 hospitalization/year, 1.42 emergency room visits/year, 1.81 years of illness and a mean dosage equivalent to olanzapine 6.75 mg/day. The incidence of psychosis in our area has been 7.01 cases per 100000 inhabitants/year.

The incidence of psychosis has been as expected according to data recorded at previous studies in Spain. The results obtained in our sample have included a lower DUP and a higher use of cannabis than those described in the literature. We have also found differences when observing the inclusion of patients in different treatments (psychotherapy, rehabilitation), which may be related to the differences in the DUP by districts. Further exploration in this field is needed to draw causal conclusions.

None Declared

Suicide, was defined as the act of intentionally taking one’s own life, understanding the lethal consequences of the act committed. The global suicide rate is 10.5 cases per 100,000 inhabitants, being lower in America, where it reaches values of 7.3 deaths per 100,000 inhabitants.

The Embera ethnic group is a Latin American indigenous people, of Chocó ethnolinguistic origin, which is located in the countries of Panama, Colombia and Ecuador; Particularly within the Embera ethnic group, a phenomenon of suicide in waves has been documented in journalistic media, which has been called “The Epidemic of the ropes”.

The data was collected in 2020, within the Río Salaquí-Isletas indigenous reservation (Riosucio-Chocó), in which multiple cases of suicide have occurred in the new millennium, without knowledge of previous cases.

To calculate the suicide rate and its trend over time in the Río Salaquí indigenous reservation, among 1999 and 2019 and compare the suicide rate and its trend with official data from Colombia, determining differences between the two.

A descriptive study with an analytical component will be carried out. The data was collected in 2020, within the Río Salaquí-Isletas indigenous reservation (Riosucio-Chocó-Colombia). The information was taked from no structurated interviews conducted with individuals from the community.

The validation of the cases and the selection of duplicate cases was carried out through checklists created by the researchers. When calculating the specific suicide rates, the estimated population in the community is obtained from official censuses and local authorities.

Statistical analysis to determine whether the suicide rate; It was carried out with the SPSS program, using a confidence interval on the rate, which would allow estimating its variability with 95% reliability.

Data of deaths by suicide were collected in people of any age, residents of the Río Salaquí Indigenous Reservation (Isletas), between the decade of 1999 and 2019, as well as the total population of the community for the calculation of suicide rates. suicide.

Among the 10 years evaluated, 22 deaths by suicide were found, of which 13 (59%) corresponded to men and 9 (41%) to women. The suicide rate in Río Salaquí for this decade was 88.8 cases per 100,000 inhabitants 95% CI (68.7-375.8), with peaks in some three-year periods analyzed and no deaths by suicide before 2001. On the other hand, the The national suicide rate in Colombia for this decade was 4.56 cases per 100,000 inhabitants 95% CI (4.18-4.87).

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During the development of the study is evident that in the indigenous reservation in the Salaqui river the suicide rate is significantly higher than in the national rates, it is even higher than the worldwide rate of suicide since the year 2001.

None Declared

Studies have reported elevated rates of dissociative symptoms and comorbid dissociative disorders in functional neurological disorder (FND); however, a comprehensive review is lacking.

To systematically review the severity of dissociative symptoms and prevalence of comorbid dissociative disorders in FND and summarise their biological and clinical associations.

We searched Embase, PsycInfo and MEDLINE up to June 2021, combining terms for FND and dissociation. Studies were eligible if reporting dissociative symptom scores or rates of comorbid dissociative disorder in FND samples. Risk of bias was appraised using modified Newcastle–Ottawa criteria. The findings were synthesised qualitatively and dissociative symptom scores were included in a meta-analysis (PROSPERO CRD42020173263).

Seventy-five studies were eligible (FND n = 3940; control n = 3073), most commonly prospective case–control studies (k = 54). Dissociative disorders were frequently comorbid in FND. Psychoform dissociation was elevated in FND compared with healthy (g = 0.90, 95% CI 0.66–1.14, I2 = 70%) and neurological controls (g = 0.56, 95% CI 0.19–0.92, I2 = 67%). Greater psychoform dissociation was observed in FND samples with seizure symptoms versus healthy controls (g = 0.94, 95% CI 0.65–1.22, I2 = 42%) and FND samples with motor symptoms (g = 0.40, 95% CI −0.18 to 1.00, I2 = 54%). Somatoform dissociation was elevated in FND versus healthy controls (g = 1.80, 95% CI 1.25–2.34, I2 = 75%). Dissociation in FND was associated with more severe functional symptoms, worse quality of life and brain alterations.

Our findings highlight the potential clinical utility of assessing patients with FND for dissociative symptomatology. However, fewer studies investigated FND samples with motor symptoms and heterogeneity between studies and risk of bias were high. Rigorous investigation of the prevalence, features and mechanistic relevance of dissociation in FND is needed.

Sleep and circadian disturbances have been widely studied in patients with bipolar disorder (BD) (Duarte Faria et al., 2015; Gonzalez, 2014). However, there is no clear evidence about the role of peripheral biomarkers of circadian cycle in this population.

This systematic review aims to identify potential endocrine biomarkers of circadian rhythm in blood and study their relationship with sleep problems in BD.

An electronic search of Pubmed and PsycoInfo databases were performed. It includes articles about the topic from 1991 to 2021. The search strategy was: (“Peripheral biomarkers” OR “biological markers” OR biomarker OR cortisol OR melatonin OR orexin OR hypocretin) AND (blood OR serum OR plasma) AND (“sleep-wake” OR “circadian rhythm” OR sleep OR insomnia) AND “bipolar”.

92 records were obtained after excluding duplicates. Only five studies met the inclusion criteria (n = 499; BD = 125; unipolar depression = 148; schizophrenia = 80; controls = 146). The endocrine parameters analyzed were: cortisol (3 studies), melatonin (1 study) and orexin-A (1 study). Overall, no significant associations between these biomarkers and sleep disturbances, assessed with subjective (psychometric evaluation) and/or objective (polysomnography) measures, were detected.

This systematic review highlights the lack of studies that explores the role of endocrine biomarkers related to circadian function in the pathophysiology of sleep disturbances in BD.

No significant relationships.

Depression treatment recommendations seldom include chronic illness comorbidity.

To describe the rationale and methods for a cluster-randomized trial (CRT) in primary care clinics (PCC) comparing a computer-assisted psychoeducational (CAPE) intervention to usual care (UC) for depressed patients with hypertension or diabetes.

Two-arm, single-blind CRT in Santiago, Chile. Eight PCC will be randomly assigned to the intervention or UC. A total of 360 depressed individuals aged 18 or older PHQ-9 scores ≥ 15 and hypertension or diabetes will be recruited. Patients with alcohol/substance abuse; current treatment for depression, bipolar disorder, or psychosis; illiteracy; severe impairment; and residents in long-term care facilities will be excluded. Patients in the intervention will receive eight CAPE sessions by trained therapists, structured telephone calls to track progress, and usual medical care for chronic diseases. Psychologists and psychiatrists will regularly supervise therapists. To ensure continuity of care, the PCC team will meet monthly with a research team member. Patients in UC will receive standard medical and depression treatment. Three, six, and twelve months after enrollment, outcomes will be assessed. The primary outcome will be a 50% reduction in baseline PHQ-9 scores at six months. Intention-to-treat analyses will be used.

A previous, small-scale pilot study provided valuable insights for study design.

This study will provide first-hand evidence on the effectiveness of a CAPE for depressed patients with chronic diseases at PCC in a Latin American country.

No significant relationships.

Long-term COVID-19 effects has been recently described as persistent and prolonged symptoms after an acute and severe SARS-COV-2 (1). An important concern is that the sequelae of severe COVID-19 may suppose a substantial outpatient 's burden for the specialized services in reopening pandemic phase (2).

To describe the frequency of mental health service use in COVID-19 hospitalized patients after discharge and to estimate the costs associated to the post- discharge consultations.

We used a 1-year follow-up cohort of 1455 COVID-19 inpatients hospitalized in La Paz University Hospital of Madrid, Spain between March 16th and April 15th, 2020. Data were retrieved from Psychiatry Service (PS) electronic health records and we described the frequency of mental health reason for consultation. We used information published by the Madrid health Office to estimate the cost of initial and following appointments.

Our sample consisted of 1,455 patients admitted with a COVID-19 diagnosis between March 16th and April 15th, 2020, and then discharged. Roughly half of them were men (776, 53%), 238 (16%) had a prior history of mental health problems, and 44 (3%) died. 193 participants (13%) visited the mental health department after being discharged. The total cost was estimated in 103,581 USD, of which two-thirds corresponded to patients with prior history of mental health problems.

Our results indicate that the mental health burden of severe COVID-19 inpatient s after discharge was substantial during the first year of follow-up. This generate important economic impact to mental health providers and society at large.

No significant relationships.

Previous reviews reported an association between Turner Syndrome (TS) and a profile of deficits in some neurocognitive domains (visual-spatial domains, mathematics, and executive functions: cognitive flexibility, working memory, cognitive inhibition, and problem solving), although pointing out individual variability.

To describe the neuropsychological profile of a patient with diagnosis of TS and psychosocial difficulties attended at the Service of Psychiatry, Clinical Psychology and Mental Health at La Paz University Hospital (Madrid).

A descriptive study is conducted on a single case of a 11-year-old woman with diagnosis of TS attended by a clinical psychologist at a child-adolescent Mental health center for social, family and academic difficulties. Neuropsychological assessment was completed in October, 2021. The Wechsler Intelligence Scale for Children-Five Edition (WISC-V) and Neuropsychological Assessment of Executive Functions in Children (ENFEN) batteries were administered.

The full-scale intelligence quotient was observed in the normal range, with lower scores in non-verbal tasks. Deficits (range from z = -2.00 to -1.75) were observed in tests of working memory, processing speed and complex problem-solving tasks. The results showed great variability in other executive functioning tasks (selective attention tasks: from z = -1.75 to -0.75; and cognitive flexibility tasks: from z = -2.25 to 0.25).

The neurocognitive profile described in the literature was partially consistent with the results obtained in this study. The neuropsychological assessment can support the elucidation of clinical diagnostic and therapeutic factors in TS patients with relevant psychosocial or cognitive difficulties.

No significant relationships.

It has been shown that long-acting treatments can significantly improve adherence, control symptom, and reduce the risk of relapse compared to oral drugs. However, limited real world evidence is available as to whether there are differences among the various formulations marketed.

This study aims to assess the impact on several prognosis variables of PP1M,PP3M,AOM and OAP drugs.

All adults (≥18 years) with schizophrenia who were initiated on PP1M, PP3M, AOM, or OAP treatment (chlorpromazine,levomepromazine,fluphenazine,haloperidol,ziprasidone,zuclopenthixol,olanzapine,quetiapine,asenapine,amisulpride, risperidone,aripiprazole,paliperidone) between 2017 and 2018 were identified in IQVIA’s database(1.8M of inhabitants from 4 Spanish areas). The rate of hospitalizations, emergency room visits, and treatment persistence was calculated using the Kaplan-Meier method. Survival curves were compared using the log-rank test (Sidak-adjustment),and Cox´s Hazard Ratios (HR) were used for the comparison between groups.

Data from 2275 patients were analyzed (PP1M= 387;PP3M=490;AOM=75;OAP=1323).The mean age of patients was 46.8(14.95) years, and 62.9% were male. The hospitalization rate at 12 months was significantly lower (p<0.01) for PP3M (8.3%) than for AOM (21.2%), PP1M (22.1%),and OAP (29.4%).When compared with PP3M use, the HRs were 2.17 for PP1M, 2.22 for AOM,and 2.90 for OAP. Emergency room visits rate at 12 months was also significantly lower (p<0. 01) for PP3M (23%) than for PP1M (36.9%), OAP (43.5%),and AOM (46.2%). Persistence rates were higher for PP3M (91%) than for any other treatment (p<0.01).

Our results outline that patients treated with PP3M experienced fewer relapses and decompensations compared to all other treatments analyzed, which might help improve the prognosis and quality of life of patients.

This study was sponsored by Janssen. M. García and P. López are employees of Janssen.

The main factors that are involved in a correct adherence to the therapeutic recommendations in Bipolar Disorder includes aspects related to age, sex, ethnicity, socioeconomic level and characteristics of the illness associated with the severity, comorbidity and adverse effects related to previous medicine.

To analyse the individual perception that the patient with Bipolar Disorder has regarding the positive and negative aspects of taking the recommended medication.

Descriptive and interpretative observational study under the qualitative paradigm of research, extracting the data through the completion of four focus groups with ten patients everyone. To complete the codification of the content of the participant’s discourses, we rely on the QRS NVivo 10 computer program.

In the participant’s discourse concerning the main barriers to pharmacological treatment, for example “It’s because we live in a society and, because of that, we don’t go without medicine; if we didn’t live in society, we wouldn’t take medicine because we wouldn’t bother anyone”. Some examples of patient’s discourse, about perceived facilitators were: “I have to take medicine for my bipolar disorder, that’s it, I have a treatment, my illness has a name”.

The main facilitators regarding the use of pharmacological treatment in Bipolar Disorder are the perceived need for treatment in the acute phase and the recognition of the illness, the shared clinical decision and the causal biological attribution in the chronic phase. About perceived barriers, social control is identified in both phases, adverse effects in the acute cases and the absence of effective treatment in the chronic state.

Bullying is a major problem worldwide and Chile is no exception. Whole school-based antibullying programs offer an opportunity for preventing bullying at school. The KiVa antibullying program has been evaluated in Finland and other European countries, showing preventive effects on self-reported bullying victimization and bullying perpetration.

To test the effectiveness of a culturally adapted version of the KiVa antibullying program in socio-economically vulnerable schools in Santiago, Chile.

We did a cluster randomized controlled trial in 5th and 6th graders at socially vulnerable schools. Schools were randomly assigned (1:1:1) to three groups: full KiVa group (including the online game), partial KiVa group (did not include the online game), and control group in which the regular school curriculum was implemented. The primary outcome was self-reported bullying victimization, measured with the Olweus Bully/Victim Questionnaire-Revised version (OBVQ-R). Students were assessed at the end of the academic year (November 2016) and 12 months later at the end of the academic year (November 2017). This trial is registered with ClinicalTrials.gov, number NCT02898324.

We included 39 schools (13 in each group). The baseline survey included a total of 5923 participants, and the endpoint survey included 3968 participants. Participants in the partial KiVa group had lower victimization and lower witnessing bullying at school at the endpoint survey than those in the control group. There was no effect of the full KiVa group. No effects were found for bullying perpetration in any of the comparisons between arms.

The KiVa antibullying Program had small effects in its implementation in Chile.